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T1 at 1.5T and 3T compared with conventional T2* at 1.5T for cardiac siderosis.

Alam, MH; Auger, D; Smith, GC; He, T; Vassiliou, V; Baksi, AJ; Wage, R; Drivas, P; Feng, Y; Firmin, DN; et al. Alam, MH; Auger, D; Smith, GC; He, T; Vassiliou, V; Baksi, AJ; Wage, R; Drivas, P; Feng, Y; Firmin, DN; Pennell, DJ (2015) T1 at 1.5T and 3T compared with conventional T2* at 1.5T for cardiac siderosis. J Cardiovasc Magn Reson, 17. p. 102. ISSN 1532-429X
SGUL Authors: He, Taigang

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BACKGROUND: Myocardial black blood (BB) T2* relaxometry at 1.5T provides robust, reproducible and calibrated non-invasive assessment of cardiac iron burden. In vitro data has shown that like T2*, novel native Modified Look-Locker Inversion recovery (MOLLI) T1 shortens with increasing tissue iron. The relative merits of T1 and T2* are largely unexplored. We compared the established 1.5T BB T2* technique against native T1 values at 1.5T and 3T in iron overload patients and in normal volunteers. METHODS: A total of 73 subjects (42 male) were recruited, comprising 20 healthy volunteers (controls) and 53 patients (thalassemia major 22, sickle cell disease 9, hereditary hemochromatosis 9, other iron overload conditions 13). Single mid-ventricular short axis slices were acquired for BB T2* at 1.5T and MOLLI T1 quantification at 1.5T and 3T. RESULTS: In healthy volunteers, median T1 was 1014 ms (full range 939-1059 ms) at 1.5T and modestly increased to 1165ms (full range 1056-1224 ms) at 3T. All patients with significant cardiac iron overload (1.5T T2* values <20 ms) had T1 values <939 ms at 1.5T, and <1056 ms at 3T. Associations between T2* and T1 were found to be moderate with y =377 · x(0.282) at 1.5T (R(2) = 0.717), and y =406 · x(0.294) at 3T (R(2) = 0.715). Measures of reproducibility of T1 appeared superior to T2*. CONCLUSIONS: T1 mapping at 1.5T and at 3T can identify individuals with significant iron loading as defined by the current gold standard T2* at 1.5T. However, there is significant scatter between results which may reflect measurement error, but it is also possible that T1 interacts with T2*, or is differentially sensitive to aspects of iron chemistry or other biology. Hurdles to clinical implementation of T1 include the lack of calibration against human myocardial iron concentration, no demonstrated relation to cardiac outcomes, and variation in absolute T1 values between scanners, which makes inter-centre comparisons difficult. The relative merits of T1 at 3T versus T2* at 3T require further consideration.

Item Type: Article
Additional Information: © 2015 Alam et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Keywords: Adult, Biomarkers, Cardiomyopathies, Case-Control Studies, Female, Humans, Image Processing, Computer-Assisted, Iron, Magnetic Resonance Imaging, Male, Middle Aged, Myocardium, Predictive Value of Tests, Prognosis, Prospective Studies, Reproducibility of Results, Siderosis, Young Adult, Myocardium, Humans, Siderosis, Cardiomyopathies, Iron, Magnetic Resonance Imaging, Prognosis, Case-Control Studies, Prospective Studies, Reproducibility of Results, Predictive Value of Tests, Image Processing, Computer-Assisted, Adult, Middle Aged, Female, Male, Young Adult, Biomarkers, Cardiac siderosis, 3 Tesla, T1 mapping, MOLLI, T2*, Cardiovascular magnetic resonance, Nuclear Medicine & Medical Imaging, 1102 Cardiovascular Medicine And Haematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: J Cardiovasc Magn Reson
ISSN: 1532-429X
Language: eng
24 November 2015Published
16 November 2015Accepted
Publisher License: Creative Commons: Attribution 4.0
Project IDFunderFunder ID
PG/09/074/27961British Heart FoundationUNSPECIFIED
PubMed ID: 26602203
Web of Science ID: WOS:000365179000001
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